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Exploratory Design (exploratory + design)
Selected AbstractsNurses' perceptions of individualized careJOURNAL OF ADVANCED NURSING, Issue 5 2010Riitta Suhonen suhonen r., gustafsson m.-l., katajisto j., välimäki m. & leino-kilpi h. (2010) Nurses' perceptions of individualized care. Journal of Advanced Nursing,66(5), 1035,1046. Abstract Title.,Nurses' perceptions of individualized care. Aim., This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. Background., Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. Methods., A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale,Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. Results., Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. Conclusion., Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care. [source] Embedding nursing and therapy consultantship: the case of stroke consultantsJOURNAL OF CLINICAL NURSING, Issue 2 2009Christopher R Burton Aims and objectives., As the basis for the design of career development opportunities for current and aspiring nursing and therapy consultants, we aimed to explore the factors that shape how these roles have embedded in UK stroke services. Background., The non-medical consultant role has been introduced into UK health care services to provide opportunities for experienced practitioners to progress their careers in clinical practice. Whilst there have been evaluations of the impact of the role on service delivery, little attention has been paid to the pathways towards consultantship. Design., An exploratory design, incorporating focus group discussions, was used to address the research questions. Participating consultants, both nurses and allied health professionals, worked in stroke services, although it is anticipated that the results will have wider application. Methods., Two focus groups were held with non-medical consultants in stroke from across the UK. Participants had the opportunity to comment on an interim paper prior to publication of the results. Thirteen consultants took part in the study. Results., A lack of consensus about the nature of clinical expertise and a diverse range of pathways towards consultantship were identified. Health care policy had presented the opportunity for consultants to be entrepreneurial in the development of stroke services, although this had limited the scope for the development of professional knowledge. Inflexible programmes to support aspiring consultants may limit the opportunities to develop these entrepreneurial skills. Conclusions., This study challenges health care organizations and the education and research departments that support them to think creatively in the way that the non-medical consultant role is embedded, and that this should draw on the commitment of existing consultants to support succession planning. Relevance to clinical practice., The identification of those aspects of career pathways that current consultants have found to be helpful will be useful in designing opportunities for aspiring consultants. [source] Autonomy through identification: a qualitative study of the process of identification used by people with type 2 diabetesJOURNAL OF CLINICAL NURSING, Issue 7b 2008Albine Moser MPH Aims and objectives., The aim of this study is to clarify the process of identification with diabetes as a dimension of autonomy as described by people with type 2 diabetes. Background., People with type 2 diabetes view autonomy as competency in shaping one's life. This concept of autonomy has seven dimensions, which emerged as categories in prior research. Dynamic processes shape these dimensions of autonomy. One of the dimensions of autonomy is identification. Method., This study has a qualitative descriptive and exploratory design and an inductive approach as described in grounded theory. Data were collected by means of in-depth interviews. The sample consisted of 15 people with type 2 diabetes mellitus in a nurse-led, shared-care setting in the Netherlands. Results., The phases of identification are comprehending, struggling, evaluating and mastering. Each phase has its own characteristics. Identifying with the diabetes is a non-linear, cyclical and continuous process because people with diabetes have to deal with changing conditions. Conclusion., The dynamics of identification is directed to a process of identifying with diabetes and its care requirement. Recognizing identification as an element of autonomy enables nurses to adopt a more patient-oriented view of autonomy. Relevance to clinical practice., Nursing that fosters the process of identification promotes autonomy. This implies that a person with diabetes should be able to identify with the nurse's interventions. Hence it is vital that nurses build supportive partnerships when providing care for such a patient. [source] Barriers to the self-care of type 2 diabetes from both patients' and providers' perspectives: literature reviewJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 1 2009Sandra PY Pun MHA Aim., To review systematically the literature about barriers to diabetes self-care from both patients' and healthcare providers' perspectives. Background., Diabetes mellitus is a global health concern due to rapidly increasing prevalence. The healthcare costs for diabetes care and related complications are high. Tight glycaemic control achieved by intensive therapy has been shown to lower the risk of complications. Despite the provision of comprehensive management programmes, patients are often unable to achieve the desired outcomes. It is essential to understand the barriers to diabetes self-care in order to promote successfully self-care behaviours. Methods., A search of OVID Medline (R), CINAHL, Cochrane Library and British Nursing Index was carried out during 1986,2007 using keywords: Type 2 Diabetes Mellitus, self care, patient compliance, patient adherence and barriers to diabetes self care. Manual searching of relevant nursing journals and sourcing of secondary research extended the search. Results., A total of 16 original research papers using various methods including survey, descriptive correlational, sequential explanatory mixed-method and qualitative exploratory design were reviewed. In total, over 8900 patients and 4550 healthcare providers were recruited from over 28 countries in these studies. Major barriers identified included psychosocial, socioeconomic, physical, environmental and cultural factors. Conclusions., Healthcare providers can enhance patient empowerment and participation with family support to achieve feasible targets. Better health care delivery systems and reforms that improve affordability, accessibility, and efficiency of care are essential for helping both providers and patients to meet desirable standards of diabetes care. Relevance to clinical practice., Understanding barriers to diabetes self-care is the first step in facilitating providers to identify their role in enabling patients to overcome these barriers. Healthcare providers can develop strategies to clarify and individualise treatment guidelines, implement continuing education, improve communication skills, and help motivate patients to achieve desired behavioral changes. [source] | ||||||||||